Little Hoppers Daycare Survey

My name is Jessica Henne.  A few years ago I was looking into starting a home daycare but did not have enough people interested.  So Im trying it again! This is a survey to give me an idea of how many families need daycare in the Max, ND area!! If you know anyone else that would be interested please email me their info or you can give them mine and/or this website!

Please take a few minutes to answer this survey on home daycare needed in Max, ND area!

1.  Do you need childcare?

Thank you for taking the time to fill out this survey and if you were interested, please leave your personal information and I will get back to you if Little Hoppers will be open!

YES

NO

2.  If Yes, how many children?

3.  Ages of children enrolled?

NAME:

b.

a.

Address:

Phone #:

c.

d.

Email:

4.  Hours you would need childcare?

AM

PM

AM

PM

Jessica Henne 3328C 27th ST NW Max, ND 58759 701-679-2256 701-661-0240 littlehoppers@hotmail.com

5.  Any other families interested?

NAME:

Ph #: